El-Fattah A M A, Kamal E, Amer H E, Fouda M, Elwahab A E M A, Tawfik A
Otolaryngology Department, Faculty of Medicine, Mansoura University, Egypt.
J Laryngol Otol. 2011 Jun;125(6):614-9. doi: 10.1017/S0022215110002537. Epub 2010 Dec 16.
Laryngotracheal stenosis is currently one of the most common complications associated with nasal and orotracheal intubation and tracheotomy. Once established, tracheal stenosis can be a complex and difficult problem to manage.
We retrospectively analysed 2004-2010 data for 12 male patients with postintubation cervical tracheal stenosis (grade III-IV) treated in the otolaryngology department, Mansoura University Hospitals. All patients had a tracheostomy at presentation, and all underwent tracheal resection with primary cricotracheal anastomosis and suprahyoid release.
Grade III stenosis was present in five patients (41.7 per cent) and grade IV stenosis in seven patients (58.3 per cent). The length of trachea resected ranged from 2 to 4 cm, representing one to four tracheal rings. In all 12 patients, the procedure allowed successful tracheotomy decannulation. Minor complications comprised surgical emphysema (n = 2) and wound infection (n = 1), and were managed conservatively. Major complications consisted of restenosis (n = 3), managed in two patients by repeated dilatation; one patient was lost to follow up.
Segmental tracheal resection with cricotracheal anastomosis was successful in 11/12 (92 per cent) patients with severe cervical tracheal stenosis. The strategy for treatment of airway stenosis is now well established and success rates are high, with minimal or no sequelae.
喉气管狭窄是目前与鼻气管插管和口气管插管及气管切开术相关的最常见并发症之一。一旦形成，气管狭窄可能是一个复杂且难以处理的问题。
我们回顾性分析了2004年至2010年在曼苏拉大学医院耳鼻喉科接受治疗的12例男性插管后颈段气管狭窄（III-IV级）患者的数据。所有患者就诊时均行气管切开术，均接受了气管切除并一期环气管吻合术及舌骨上松解术。
5例患者（41.7%）为III级狭窄，7例患者（58.3%）为IV级狭窄。切除的气管长度为2至4厘米，相当于1至4个气管环。所有12例患者术后均成功拔除气管切开套管。轻微并发症包括手术性气肿（n = 2）和伤口感染（n = 1），均经保守治疗。主要并发症为再狭窄（n = 3），2例患者经反复扩张治疗；1例患者失访。
12例严重颈段气管狭窄患者中，11例（92%）行节段性气管切除并环气管吻合术成功。目前，气道狭窄的治疗策略已确立，成功率高，后遗症极少或无后遗症。
